Transvaginal scan cervical length measurement versus bishop score prior to induction of labour: A randomised controlled study in Osogbo Metropolis, Osun State, Nigeria

Abstract

Induction of labour (IOL) is a common procedure, occurring in 20-25% of pregnancies, yet around 20% of women undergoing IOL require  caesarean section. The traditional Bishop Score (BS) for assessing cervical readiness is subjective and has limited predictive value. This  study evaluated the effectiveness of transvaginal ultrasound (TVS) measurement of cervical length as an alternative to BS in predicting  IOL outcomes. A randomized controlled trial was conducted among 76 pregnant women with indications for IOL at Osun State University  Teaching Hospital, Osogbo, Nigeria, with participants assigned to either the TVS group (n=38) or the BS group (n=38). Primary outcomes  included mode of delivery, delivery interval, analgesia, oxytocin use and Apgar scores. Data were analysed using IBM SPSS Statistics V20,  with statistical significance set at p<0.05. Results showed that the TVS group had a higher rate of spontaneous vaginal delivery (84.2% vs. 73.2%), shorter induction-to-delivery intervals (5.71±2.32 hours vs. 7.26±2.34 hours), less postpartum blood loss (396.05±17.12 mL vs.  485.53±17.98 mL), and better neonatal Apgar scores at one  and five minutes (7.21±1.54 vs. 5.09±1.62 and 9.16±0.72 vs. 6.18±1.77,  respectively). In conclusion, TVS measurement of cervical length prior to IOL was associated with shorter delivery times, reduced blood  loss, and improved neonatal outcomes.